U.S. patent number 8,900,137 [Application Number 13/457,484] was granted by the patent office on 2014-12-02 for cervical retractor.
This patent grant is currently assigned to NuVasive, Inc.. The grantee listed for this patent is Michael Brotman, Nathan Lovell, Kenneth Rich, Michael Serra, Andrew Wolf. Invention is credited to Michael Brotman, Nathan Lovell, Kenneth Rich, Michael Serra, Andrew Wolf.
United States Patent |
8,900,137 |
Lovell , et al. |
December 2, 2014 |
Cervical retractor
Abstract
An anterior cervical retractor comprises a retractor body having
a base arm and a moving arm and a pair of retractor blades having a
side loading blade and a top loading blade. The base arm includes a
first track and a side loading connector. The first track extends
perpendicularly from a proximal end of the base arm and the first
track includes an articulating arm post and a gear teeth. The
moving arm is located opposite to the base arm and includes a first
track receptacle and a top loading connector. The moving arm is
advanced along the first track by means of a knob extending from
the base arm. The side loading blade includes a first blade portion
and a first connection post and the top loading blade includes a
second blade portion and a second connection post.
Inventors: |
Lovell; Nathan (Oceanside,
CA), Serra; Michael (San Diego, CA), Brotman; Michael
(San Diego, CA), Wolf; Andrew (Del Mar, CA), Rich;
Kenneth (Raleigh, NC) |
Applicant: |
Name |
City |
State |
Country |
Type |
Lovell; Nathan
Serra; Michael
Brotman; Michael
Wolf; Andrew
Rich; Kenneth |
Oceanside
San Diego
San Diego
Del Mar
Raleigh |
CA
CA
CA
CA
NC |
US
US
US
US
US |
|
|
Assignee: |
NuVasive, Inc. (San Diego,
CA)
|
Family
ID: |
51948305 |
Appl.
No.: |
13/457,484 |
Filed: |
April 26, 2012 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
|
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61479307 |
Apr 26, 2011 |
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Current U.S.
Class: |
600/232; 600/213;
600/210; 600/215; 600/219 |
Current CPC
Class: |
A61B
17/02 (20130101); A61B 17/0206 (20130101); A61B
2017/00566 (20130101); A61B 2217/005 (20130101) |
Current International
Class: |
A61B
17/02 (20060101) |
Field of
Search: |
;600/201,204,205,210,213-219,221,222,227-234 ;606/90,105
;16/337,321 ;403/144 |
References Cited
[Referenced By]
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Primary Examiner: Schaper; Michael T
Assistant Examiner: Kamikawa; Tracy
Attorney, Agent or Firm: Spangler; Jonathan Schermerhorn;
Rory
Parent Case Text
CROSS REFERENCES TO RELATED APPLICATIONS
This application claims the benefit of priority under 35 U.S.C.
119(e) from U.S. Provisional Patent Application Ser. No. 61/479,307
filed on Apr. 26, 2011 the entire contents of which are each hereby
expressly incorporated by reference into this disclosure as if set
forth in its entirety herein.
Claims
What is claimed is:
1. An anterior cervical retractor for application to an anterior
part of a cervical spine, comprising: a retractor body, said
retractor body comprising: a base arm including a track base, a
side loading blade connector coupled to a distal end of said track
base, and a track extending perpendicularly from a proximal end of
said track base, said track including gear teeth said side loading
blade connector including a first top surface, a first bottom
surface, a first rear end coupled to said track base, a first front
end, and first opposing sides, said side loading blade connector
having an open receptacle that extends through the first top and
first bottom surfaces and opens in the first front end of the side
loading blade connector, said side loading blade connector further
including a first pair of locking arms, each of the locking arms of
the first pair of locking arms including a release tab and a
locking tooth; a moving arm including a track receptacle and a top
loading blade connector coupled to a distal end of said track
receptacle, said track receptacle configured to receive said track
therethrough, said moving arm advanceable along said track by
rotation of a knob extending from said base arm, said knob
connected to a gear that extends into said track receptacle and
engages said gear teeth, said top loading blade connector including
a second top surface, a second bottom surface, a second rear end
coupled to said track receptacle, a second front end, and second
opposing sides, said top loading blade connector having a closed
receptacle that extends through the second top and second bottom
surfaces and is enclosed by the second front end, second rear end,
and second opposing sides, said top loading blade connector further
including a second pair of locking arms, each of the locking arms
of the second pair of locking arms including a second release tab
and a tapered wedge; a pair of retractor blades, said pair of
retractor blades comprising: a side loading blade attachable to
said side loading blade connector, said side loading blade
including a first blade portion and a first connection post, said
first blade portion having a first interior face, a first exterior
face and a first distal end, said side loading blade configured to
attach to the side loading blade connector by advancing said first
connection post into said open receptacle through said opening in
said first front end of said side loading blade connector, and
wherein the first blade portion is rotatable about a limited range
relative to at least a portion of the first connection post such
that the first blade portion is rotatable about a limited range
relative to the base arm when said side loading blade is attached
to said side loading blade connector; and a top loading blade
attachable to said top loading blade connector, said top loading
blade including a second blade portion and a second connection
post, said second blade portion having a second interior face, a
second exterior face and a second distal end, said top loading
blade configured to attach to the top loading blade connector by
advancing said second connection post into said closed receptacle
in a direction such that the second connection post enters the
closed receptacle from the second bottom surface, wherein said
second connection post is fixed relative to said second blade
portion and said second connection post is rotatable about a
limited range relative to the top loading blade connector such that
the second blade portion is rotatable about a limited range
relative to the moving arm when said top loading blade is attached
to said top loading blade connector.
2. The anterior cervical retractor of claim 1, wherein each of said
locking arms of said first pair of locking arms is biased such that
the respective locking tooth extends into the open receptacle to
capture said first connection post of said side loading blade in
said open receptacle.
3. The anterior cervical retractor of claim 2, wherein operating
said release tabs of said first pair of locking arms disengages
each locking tooth from the first connection post to remove the
side loading blade from the side loading blade connector.
4. The anterior cervical retractor of claim 3, wherein each of said
locking arms of said second pair of locking arms is biased such
that the respective tapered wedge extends into the closed
receptacle to capture said second connection post of said top
loading blade in said closed receptacle and wherein operating said
second release tabs of said second pair of locking arms disengages
each tapered wedge from said second connection post to remove said
top loading blade from said top loading blade connector.
5. The anterior cervical retractor of claim 1, wherein said side
loading blade connector is coupled to said track base via a first
pivot piece, the first pivot piece being pivotally coupled at one
end to the side loading blade connector and being pivotally coupled
at an opposite end to the track base such that a height of said
side loading blade connector is adjustable relative to said track
base while maintaining an alignment of said side loading blade
connector parallel to said track base, said first pivot piece
further including a first friction mechanism for preventing said
side loading blade connector and said first pivot piece from
flopping around.
6. The anterior cervical retractor of claim 5, wherein said first
friction mechanism includes a first spring and a pair of first
friction nubs, each of the pair of first friction nubs situated at
an opposite end of the first spring, and wherein one of said first
friction nubs creates friction between said first pivot piece and
said side loading blade connector and the other of said first
friction nubs creates friction between said first pivot piece and
said track base.
7. The anterior cervical retractor of claim 1, wherein said top
loading blade connector is coupled to said track receptacle via a
second pivot piece, said second pivot piece being pivotally coupled
at one end to the top loading blade connector and being pivotally
coupled at an opposite end to the track receptacle such that a
height of said top loading blade connector is adjustable relative
to said track receptacle while maintaining alignment of said top
loading blade connector parallel to said track receptacle, said
second pivot piece further including a second friction mechanism
for preventing said top loading blade connector and said second
pivot piece from flopping around.
8. The anterior cervical retractor of claim 7, wherein said second
friction mechanism includes a second spring and a pair of second
friction nubs, each of the pair of second friction nubs situated at
an opposite end of the second spring, and wherein one of said
second friction nubs creates friction between said second pivot
piece and said top loading blade connector and the other of said
second friction nubs creates friction between said second pivot
piece and said track receptacle.
9. The anterior cervical retractor of claim 1, wherein at least one
of said side loading blade and said top loading blade includes a
suction channel designed to receive and maintain a suction
instrument within said retractor.
10. The anterior cervical retractor of claim 1, wherein said
rotation of the first blade portion about the limited range
relative to the base arm and rotation of the second blade portion
about the limited range relative to the moving arm facilitates
self-alignment of the side loading and top loading blades to reduce
pressure points on retracted tissue.
11. The anterior cervical retractor of claim 1, wherein said first
connection post includes an upper tier and a lower tier such that
said side loading blade is attachable to two instruments
simultaneously.
12. The anterior cervical retractor of claim 11, wherein said
second connection post includes an upper tier and a lower tier such
that said top loading blade is attachable to two instruments
simultaneously.
13. The anterior cervical retractor of claim 11, wherein one of
said instruments is an insertion handle and a second of said
instruments is the retractor body.
14. The anterior cervical retractor of claim 1, wherein said first
distal end of said first blade portion is one of blunt and
toothed.
15. The anterior cervical retractor of claim 1, wherein said second
distal end of said second blade portion is one of blunt and
toothed.
16. The anterior cervical retractor of claim 1, wherein the track
receptacle includes an articulating arm post for rigid connection
of the retractor body to a stationary object.
Description
TECHNICAL FIELD
This application describes surgical retractors useful for creating
and maintaining an access corridor to the cervical spine.
BACKGROUND
Retractors are often used to assist surgeons during procedures.
During spinal procedures for example, retractors are used to
maintain an operative corridor free of body tissue from the
exterior of the patient to the spinal target site. Procedures
performed on the anterior cervical spine, for example, discectomy,
fusion, disc replacement, etc. . . . are often performed with the
aid of the retractor. These procedures are used to treat symptoms
from cervical disc diseases or traumas such as cervical
radiculopathy, disc herniations, fractures, and spinal
instability.
In order to perform the anterior cervical discectomy, an incision
incision is made through the neck and retractors are then used to
gently separate and hold the neck muscles and soft tissues apart so
that the surgeon can work on the front portion of the cervical
spine. While there are a number of cervical retractors available
for use, there remains room for improvement of cervical retractor
offerings. For example, cervical retractors often use retractor
blades that are fixed in a single position. These retractor blades
are unable to adjust or move with the tissue as the tissue is
retracted and pressure points can arise potentially causing
unnecessary morbidity to the surrounding tissue. Other retractors
used blades that are free to rotate relative to the retractor body.
However, because these blades can rotate freely correctly aligning
them during retractor deployment can also be a challenge.
Additionally, retractors often have many parts that are free to
move relative, which may be beneficial to achieve a desired
retractor position, but which can lead to difficulty in handling
the retractors outside of body.
The retractor, instruments, and methods described herein are aimed
at addressing these and other challenges that currently exist.
BRIEF DESCRIPTION OF THE DRAWINGS
Elements in the figures have not necessarily been drawn to scale in
order to enhance their clarity and improve understanding of these
various elements and embodiments of the invention. Furthermore,
elements that are known to be common and well understood to those
in the industry are not depicted in order to provide a clear view
of the various embodiments of the invention, thus the drawings are
generalized in form in the interest of clarity and conciseness.
FIG. 1 is a perspective view of an anterior cervical retractor
according to one example embodiment;
FIG. 2 is a perspective view of the cervical retractor of FIG. 1
without the retractor blades engaged;
FIG. 3 is a cross section view of the cervical retractor of FIG.
2;
FIGS. 4-6 are front perspective, back perspective, and side
exploded views of a side loading retractor blade, according to one
example embodiment;
FIGS. 7-9 are front perspective, back perspective, and side
exploded views of a top loading retractor blade, according to one
example embodiment;
FIG. 10 a perspective view of an insertion handle for use with the
side loading retractor blade of FIGS. 4-6 and the top loading
retractor blade of FIGS. 7-9, according to one example
embodiment;
FIG. 11 is an exploded view of the insertion handle of FIG. 10;
FIG. 12 is a perspective view of an articulating arm connector for
securing the retractor relative to the surgical table or other
stationary object with an articulating arm, according to one
example embodiment; and
FIG. 13 is an exploded view of the articulating arm connector of
FIG. 12.
DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT
Illustrative embodiments are described below. In the interest of
clarity, not all features of an actual implementation are described
in this specification. It will of course be appreciated that in the
development of any such actual embodiment, numerous
implementation-specific decisions must be made to achieve the
developers' specific goals, such as compliance with system-related
and business-related constraints, which will vary from one
implementation to another. Moreover, it will be appreciated that
such a development effort might be complex and time-consuming, but
would nevertheless be a routine undertaking for those of ordinary
skill in the art having the benefit of this disclosure. The
anterior cervical retractor disclosed herein boasts a variety of
inventive features and components that warrant patent protection,
both individually and in combination.
With reference to FIG. 1, a cervical retractor 102 according to one
example embodiment is depicted. The cervical retractor 2 is well
suited for creating an operative corridor to a cervical spine
target site, particularly for a single level procedure (e.g.
discectomy, fusion, disc replacement, etc. . . . ). The cervical
retractor 102 includes a base arm 104 and a moving arm 106 and, a
pair of retractor blades 108 having a side loading blade 110 and a
top loading blade 112. The base arm 104 includes a track base 118
and a side loading connector 116 that connects the side loading
blade 110. The side loading connector 116 is connected to the track
base 118 by a pivot link 117 having two pivots 119 such that the
base arm comprises a double hinge. A first track 114 extends
perpendicularly from the track base 118 of the base arm 104, the
first track 114 including a row of teeth 120. The moving arm 106 is
located opposite to the base arm 104. The moving arm 106 includes a
first track receptacle 122 and a top loading connector 124 that
connects the top loading blade 112. The top loading connector 124
is connected to the track receptacle 122 by a pivot link 126 having
two pivots 128 such that the moving arm comprises a double hinge.
The moving arm 106 may be advanced along the first track 114 by
means of a knob 130 to move the moving arm 106 away from the base
arm 104. The moving arm 106 also includes an articulating arm post
132 which provides a connection point for rigidly attaching the
first retractor 102 to the surgical table (or other stationary
object) with a locking articulating arm.
In surgical use, according to a preferred example, the base arm 104
and the side loading connector 116 are positioned medially (away
from the surgeon) and against the esophagus and trachea. The moving
arm 106 and the top loading connector 124 is positioned laterally
(closest to the surgeon). Hence, the side loading blade 110 and the
top loading blade 112 may also be referred to as medial blade and
lateral blade, respectively. The retractor 102 may be then used to
retract the tissue in a medial-lateral orientation.
The base arm 104 and moving arm 106 are best illustrated in FIGS.
2-3. The side loading connector 116 is connected to the track base
118 by pivot link 117. The pivot link 117 includes a pair of pivots
119 with one pivot 119 located on each end of the pivot link 117 to
permit variability in the height of the side loading connector 116
relative to the track base 118 while maintaining the alignment of
the side loading connector 116 generally parallel to the track base
118. The pivot link 117 further includes a friction mechanism 134
for preventing the side loading connector 116 and the pivot link
117 from flopping around. The friction mechanism 134 includes a
spring 136 with a pair of friction nubs 138 situated at each end.
The friction mechanism 134 creates friction between the first pivot
link 117 and the side loading connector 116, and between the pivot
link 117 and the track base 118. The friction between the pivot
link 117 and each of the side loading connector 116 and the track
base 118 is such that the application of force (e.g. directly from
the user or from contact with the patient or another retractor,
etc. . . . ) is required to adjust the position of the side loading
connector 116. This way the side loading connector 116 and pivot
link 117 will not flop around and create a disturbance when
handling the retractor 102 and particularly when trying to position
the retractor 102 in the patient.
The side loading connector 116 includes an open receptacle 140
opening in the free end of the connector 116. Situated along each
side of the side loading connector 116 are locking arms 142 that
each include a release tab 144 at one end and a locking tooth 146
at the opposite end, the release tab 144 and locking tooth 146
being separated by a pivot 148 that pivotally connects the locking
arms 142 to the connector 116. Each of the locking arms 142 is
spring loaded with a spring 150 that biases the locking tooth 146
into the open receptacle 140 where it engages with connection post
of the side loading retractor blade 110 to lock the blade 110 to
the connector. To disengage the side loading blade from the side
loading connector 116, the release tabs 144 are depressed which
causes the teeth 146 to withdraw into the connector clearing the
way for removal of the connection post from the open receptacle
140. A tapered front edge on tooth 146 permit loading of the blade
without depressing the release tab 144 to clear the tooth out of
the open receptacle 140.
The top loading connector 124 is connected to the track receptacle
122 by pivot link 126. The pivot link 126 includes a pair of pivots
128 with one pivot 128 located on each end of the pivot link 126 to
permit variability in the height of the top loading connector 124
relative to the track receptacle 122 while maintaining the
alignment of the top loading connector 124 generally parallel to
the track receptacle 122. The pivot link 126 further includes a
friction mechanism 134 for preventing the top loading connector 124
and the pivot link 126 from flopping around. The friction mechanism
134 includes a spring 136 with a pair of friction nubs 138 situated
at each end. The friction mechanism 134 creates friction between
the first pivot link 126 and the top loading connector 124, and
between the pivot link 126 and the track receptacle 122. The
friction between the pivot link 126 and each of the top loading
connector 124 and the track receptacle 122 is such that the
application of force (e.g. directly from the user or from contact
with the patient or another retractor, etc. . . . ) is required to
adjust the position of the top loading connector 124. This way the
top loading connector 124 and pivot link 126 will not flop around
and create a disturbance when handling the retractor 102 and
particularly when trying to position the retractor 102 in the
patient.
The track receptacle 122 has a passage 152 through which the track
114 passes and which permits the moving arm 106 to translate along
the track 114. The moving arm 106 is advanced towards or away from
the base arm 104 by turning the knob 130. A gear 154 on the knob
130 extends into track receptacle passage 152 and engages the teeth
120 such that rotation of the knob 130 translates the moving arm
106 along the track either towards or away from the base arm 104,
depending on the direction of rotation. The movement of the moving
arm 106 towards the base arm 104 is prevented by a lock 156 that
engages the track teeth 120 in such a way that motion away from the
base arm 106 is permitted while motion towards the base arm is
inhibited. By way of example, the lock 156 may be a spring biased
pawl pivotally coupled to the track receptacle. The knob 130 may
preferably include a friction mechanism to prevent the knob 126
from flopping around. For example, the friction mechanism (not
shown) may be similar to the friction mechanism 134 that includes a
spring biased friction nub in contact with a hinged portion of the
knob. A protrusion 158 on the end of the track 114 prohibits the
track receptacle 122 from disengaging from the track 114.
The top loading connector 124 includes a closed receptacle 160
enclosed by the connector 124. Situated along each side of the top
loading connector 124 are locking arms 162 that each include a
release tab 164 at one end and a locking wedge 166 at the opposite
end, the release tab 164 and locking wedge 166 being separated by a
pivot 168 that pivotally connects the locking arms 162 to the
connector 124. Each of the locking arms 162 is spring loaded with a
spring 168 that biases the locking wedge 166 into the closed
receptacle 160 where it engages with connection post of the top
loading retractor blade 112 to lock the blade 112 to the connector
124. To disengage the top loading blade from the top loading
connector 124, the release tabs 164 are depressed which causes the
wedges 166 to withdraw into the connector, clearing the way for
removal of the connection post from the closed receptacle 160. An
upward tapering bottom surface of the locking wedges 166 permit
loading of the blade without depressing the release tab 166 to
clear the locking wedges from the closed receptacle 160.
FIGS. 4-6 depict the side loading blade 110. The side loading blade
110 includes a blade portion 171 and a connection post 182. The
blade portion 171 includes an interior face 172 that faces the
operative corridor, an exterior face 174 that faces and engages the
body tissue adjacent the operative corridor, a ledge 176 that
extends transversely away from the exterior face 174 at a proximal
end 177 of the blade portion, and a distal end 178. The interior
face 172 includes a shim track 180 that slidably couple a shim and
or lighting elements (not shown). The side loading blade 110 may
also include at least one suction channel 200 having a suction
receptacle 202 and a suction outlet 204. The at least one suction
channel 200 is designed to receive and hold a suction instrument
within the operative corridor. The distal end 178 may have any
number of suitable configurations, including blunt or toothed. The
distal end 178 may also be angled away from the interior.
The connection post 182 is coupled to the ledge 176 and serves as
an attachment structure for coupling the side loading blade 110 to
the side loading connector 116. The connection post 180 includes an
upper tier 184, a lower tier 186, an inner post 188, an outer post
190 and a friction element 192. The connection post 182 is designed
to provide limited rotation relative to the blade portion 171 such
that the side loading blade 110 is configured to self align during
retraction to reduce pressure points on retracted tissue. The inner
post 188 and the outer post 190 of the connection post 182 are
connected by an attachment pin 194. The inner post 188 further
includes a slot 196 to allow the attachment pin 194 to pass
through. The slot 196 receives the attachment pin 194 and allows
the outer post 190 and the attachment pin 194 to rotate. The width
of the slot 196 is made larger than the width of the attachment pin
194 so as to allow the attachment pin 194 to move freely in the
slot 196. The friction element 162 helps to control rotation of the
inner post 188 within the outer post 190. The friction element 192
may be an o-ring. The inner post 188 is fixed to the blade portion
171 with a first connection post set screw 198. Having both the
upper tier 184 and the lower tier 186 allows the side loading blade
110 to be connected to two instruments simultaneously. For example,
the blade may be inserted through a skin incision while connected
to a manual insertion handle. Then the connection post 182 may be
coupled to the side loading connector 124 prior to removing the
manual handle such that retraction is not lost while engaging the
blade 110 and connector 124. Alternatively, the blade 110 may be
connected directly to an articulating arm (instead of being
attached to retractor 102) while it is connected to a manual
insertion handle.
With reference to FIGS. 7-9 the top loading blade 112 is depicted.
The top loading blade 112 includes a blade portion 171 and a
connection post 208. The blade portion 171 is the same as blade
portion 171 of the side loading retractor blade 110. For example,
the blade portion includes interior face 172 that faces the
operative corridor, an exterior face 174 that faces and engages the
body tissue adjacent the operative corridor, a ledge 176 that
extends transversely away from the exterior face 174 at a proximal
end 177 of the blade portion, and a distal end 178. The interior
face 172 includes a shim track 180 that slidably couple a shim and
or lighting elements (not shown). The blade portion 171 of top
loading blade 112 may also include at least one suction channel 200
having a suction receptacle 202 and a suction outlet 204. The at
least one suction channel 200 is designed to receive and hold a
suction instrument within the operative corridor. The distal end
178 may have any number of suitable configurations, including blunt
or toothed. The distal end 178 may also be angled away from the
interior. The top loading blade 112 differs from the side loading
blade 110 in the connection post 208 that is connected to the blade
portion 171.
The top loading connection post 208 is coupled to the ledge 176 and
serves as an attachment structure for coupling the top loading
blade 112 to the top loading connector 124. The connection post 208
includes an upper tier 210 and a lower tier 212. The connection
post 208 permits rotation of the top loading blade 112 such that
the top loading blade 112 self aligns and reduces pressure points
on the retracted tissue. Unlike the side loading connector post
182, which rotates (about a limited range) relative to the blade
portion 171, the top loading connection post 208 is fixed (via set
screw 214) relative to the blade portion 176. Instead, the
connection between the upper tier 210 of the connection post 208
and the top loading connector 124 provides for the rotation.
Specifically, side grooves 216 formed in the upper tier 210 receive
the locking wedges 166. The depth of the side grooves 216 provide
for space between the wedges 166 and the inner walls of the grooves
166 which allows rotation (about a limited range) of the top
loading blade 112 relative to the top loading connector 124. Having
the upper tier 210 and the lower tier 212 allows the top loading
blade 112 to be connected to two instruments simultaneously. For
example, the blade 112 may be inserted through a skin incision
while a manual insertion handle is connected to the lower tier 212.
With the manual handle still connected to the lower tier 212, the
top loading connector may be attached to the upper tier 210 of the
connection post 208 such that retraction is not lost while engaging
the blade 110 and connector 124. Alternatively, the blade 112 may
be connected directly to an articulating arm (instead of being
attached to retractor 102) while it is connected to a manual
insertion handle.
FIGS. 10-11 illustrate an insertion handle 218 for advancing the
side loading blade 110 and the top loading blade 112 to cervical
target site. The insertion handle 218 comprises a grip 220, an
outer shaft 222, a lever 224, an inner shaft 226 and an engagement
head 228. The engagement head 228 further comprises an open
receptacle 229 and a pair of locking arms 230 situated along each
side of the side engagement head. Each locking arm 230 includes a
tapered engagement extension 232 at one end and a locking tooth 234
at the opposite end, the engagement extension 232 and locking tooth
234 being separated by a pivot 236 that pivotally connects the
locking arms 230 to the engagement head 228. The locking arms 230
are spring loaded with a spring 238 that biases the locking teeth
234 into the open receptacle 140 where it engages with either the
side loading connection post 182 or the top loading connection post
208. On the side loading blade 110, the insertion handle 218 can
connect to either the lower tier 186 or the upper tier 184 of the
connection post 182. On the top loading blade 112, the insertion
handle 218 can connect to the lower tier 212. A tapered front edge
on teeth 234 permit loading of the blade without clearing the teeth
234 out of the open receptacle 229. To withdraw the teeth 234 from
the open receptacle and disengage the retractor blade, the lever 22
is depressed. The lever 224 is attached to the inner shaft 226 such
that depressing the lever causes the inner shaft 226 to translate
towards the engagement head 228. Engagement prongs 240 on the
distal end of the inner shaft 226 contact the engagement extensions
232 of the locking arms and force them to move towards each other.
The locking arms 230 thus rotate about the pivot 236 and the
locking teeth are withdrawn out of the open receptacle 290, freeing
the blade 110 or 112.
FIGS. 12-13 illustrate an articulating arm connector 242 for
attachment to an articulating arm post 132 of the cervical
retractor 102. The articulating arm connector 242 attaches to a
free end of the articulating arm (not shown) which may be secured
at the opposite end to the surgical table or other stationary
object, thus securing the position of the retractor 102 relative to
the table. The articulating arm connector 242 includes an
engagement head 244 with an open receptacle 247 opening in the free
end of the c engagement head 244. Situated along each side of the
engagement head 244 are locking arms 246 that each include a
release tab 248 at one end and a locking tooth 250 at the opposite
end, the release tab 248 and locking tooth 250 being separated by a
pivot 252 that pivotally connects the locking arms 246 to the
engagement head 244. Each of the locking arms 246 is spring loaded
with a spring 254 that biases the locking tooth 250 into the open
receptacle 247 where it engages with articulating arm post 132 to
lock the retractor 102 to the articulating arm. The articulating
arm connector also includes a translating post 256 which is
threadedly coupled to a thumbwheel 258. The translating post 256
can be actuated to advance into the open receptacle 256 where it
presses against the articulating arm post 132 to provide for a
sturdier connection. To disengage the articulating arm connector
242, the release tabs 248 are depressed which causes the teeth 250
to withdraw into the engagement head clearing the way for removal
of the articulating arm post 132 from the open receptacle 247. A
tapered front edge on teeth 250 permit initial loading of the
articulating arm post 132 without depressing the release tab 248 to
clear the teeth out of the open receptacle 247.
According to one example, a method of creating an operative
corridor to a cervical target site with the retractor 102 is
initiated by attaching the side loading blade 110 to the insertion
handle 218 via one tier (184, 186) of the first connection post
182. The side loading blade 110 is then retracted into the desired
position with the insertion handle and then the blade 110 is locked
in place with the articulating arm. To do so the articulating arm
connector 242 is connected to the free tier (i.e. the tier that is
not connected to the insertion handle 218) of the connection post
182. The articulating arm is then locked, fixing the position of
the side loading blade 110. The insertion handle 218 is then
removed to free a tier of the connection post 182 and the side
loading connector 116 of the retractor body 102 is then attached to
the free tier. The top loading blade 112 is then attached to the
insertion handle 218 by connecting the insertion handle 218 to the
lower tier 212 of the connection post 208. The top loading blade
112 is manually retracted into the desired position and then the
top loading connector 124 is attached to the upper tier 210 of the
connection post 208. The insertion handle 218 is removed from the
lower tier 212. The retractor 100 may then be utilized to retract
tissue, for example in a medial-lateral orientation.
While the invention is susceptible to various modifications and
alternative forms, specific embodiments thereof have been shown by
way of example in the drawings and are herein described in detail.
It should be understood, however, that the description herein of
specific embodiments is not intended to limit the invention to the
particular forms disclosed, but on the contrary, the invention is
to cover all modifications, equivalents, and alternatives falling
within the spirit and scope of the invention as defined herein.
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